Refractory gastroparesis can be successfully managed with endoscopic transpyloric stent placement and fixation (with video)

Khashab, Mouen A.; Besharati, Sepideh; Ngamruengphong, Saowanee; Kumbhari, Vivek; Zein, Mohamad El; Stein, Ellen M.; Tieu, Alan H.; Mullin, Gerard E.; Dhalla, Sameer; Nandwani, Monica; Singh, Vikesh K.; Canto, Marcia I.; Kalloo, Anthony N.; Clarke, John O.

doi:10.1016/j.gie.2015.06.051

Cited by 97 publications

(51 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Based on these principles, Khashab and colleagues 8 The current report is in line with the above results, which suggest that interventions directed at the pylorus improve gastroparetic symptoms in a significant proportion of patients. The shortcoming of botulinum toxin injection is suboptimal efficacy and short duration of action.…”

Section: Discussionsupporting

confidence: 86%

See 1 more Smart Citation

Gastric per-oral endoscopic myotomy for refractory gastroparesis: results from the first multicenter study on endoscopic pyloromyotomy (with video)

Khashab

Ngamruengphong

Carr‐Locke

et al. 2017

Gastrointestinal Endoscopy

Self Cite

195

135

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 86%

“…The main drawback of transpyloric stenting is stent migration, which is seen in most patients even after anchorage with endoscopic suturing or clipping. 8 Finally, surgical pyloroplasty for gastroparesis is invasive. Endoscopic pyloromyotomy or G-POEM is potentially an ideal therapy for such patients.…”

Section: Discussionmentioning

confidence: 99%

Gastric per-oral endoscopic myotomy for refractory gastroparesis: results from the first multicenter study on endoscopic pyloromyotomy (with video)

Khashab

Ngamruengphong

Carr‐Locke

et al. 2017

Gastrointestinal Endoscopy

Self Cite

195

135

View full text Add to dashboard Cite

“…71,72 A guidewire is advanced into the distal duodenum, and the self-expandable metal stent delivery system is placed over the guidewire. The stent is deployed under endoscopic visualization, such that the proximal flared end is in the antrum and the distal flared end in the duodenum proximal to the duodenal papilla.…”

Section: Pyloric Interventionsmentioning

confidence: 99%

Novel Diet, Drugs, and Gastric Interventions for Gastroparesis

Camilleri

2016

Clinical Gastroenterology and Hepatology

View full text Add to dashboard Cite

This review of the pathophysiological basis for gastroparesis and recent advances in the treatment of patients with gastroparesis shows that there are several novel approaches to advance treatment of gastroparesis including diet, novel prokinetics, interventions on the pylorus, and novel forms of gastric electrical stimulation. The field of gastroparesis is likely to advance with further studies, with the help from a guidance document from the FDA on gastroparesis, and with the recent approval of the stable isotope gastric emptying test to ensure eligibility of participants in multicenter trials. Clinical experience and a formal, randomized, controlled trial provide insights on optimizing dietary interventions in patients with gastroparesis. This review addresses the biological rationale of these different treatments, based on known physiology and pathophysiology of gastric emptying. The novel medications include the motilin agonist, camicinal, 5-HT4 receptor agonists such as velusetrag, and the ghrelin agonist, relamorelin. New approaches target pylorospasm by either stent placement, endoscopic pyloric myotomy or laparoscopic pyloroplasty. These approaches offer the opportunity to achieve more permanent reduction of resistance to flow at the pylorus over the intrapyloric injection of botulinum toxin, which typically has to be repeated every few months if it is efficacious. A novel device, deployed in porcine stomach, involved per-endoscopic electrical stimulation. These promising approaches require formal, randomized, controlled trials and deployment in patients. The presence of concomitant antral hypomotility may be a significant factor in the responsiveness to interventions at the pylorus.

show abstract

“…Moreover, positive effects were demonstrated for the therapy with stents inserted into the pyloric canal. In the population studied, nausea and vomiting were alleviated [44]. Pyloroplasty was also found to be highly effective.…”

Section: Description Of the State Of Knowledgementioning

confidence: 87%

Diabetic autonomic neuropathy of the gastrointestinal tract – etiopathogenesis , diagnosis, treatment and complications

Kuzemko¹,

Rymarz²,

Prystupa³

et al. 2017

J Pre Clin Clin Res.

View full text Add to dashboard Cite

Introduction. Late complications of diabetes mellitus are a serious challenge for physicians treating diabetic patients. Micro-and macro-angiopathic changes are of the most severe sequels. However, it should be remembered that the effects of long-term diabetes are also associated with changes in the peripheral nervous system. One of the complications most troublesome for patients is diabetic autonomic neuropathy of the gastrointestinal (GI) tract. Objective. The review article presents the pathogenesis of diabetic neuropathy of the autonomous gastrointestinal tract, and advances in the diagnosis and treatment of this disease. The study used materials in the database which demonstrate current standards of conduct, based on the principles of EBM. Brief description of the state of knowledge. Diabetic neuropathy is one of the most common complications of diabetes mellitus. According to epidemiologists, it affects 10% to even 100% of patients with long-standing disease. Damage to the nervous fibres mainly results from hyperglycaemia, which leads to the typical symptoms of dysfunction of GI tract segments. The main additional examinations include abdominal ultrasound (US) and abdominal X-ray. In cases with oesophageal disorders accompanied by dysphagia, gastroscopy is found useful for excluding possible neoplastic lesions. The gold standard for evaluation of gastric emptying is radioisotopic scintigraphy, however it is available only in some specialistic departments. Other recommended methods include: manometry, EGG, insulin tests, NMR and expiratory tests. To date, the problem has been managed symptomatically; in special cases, surgical interventions have been required. Conclusions. At present, a wide array of treatment options is available, including new forms of drugs and less radical surgical procedures carried out in numerous centres worldwide.

show abstract

Refractory gastroparesis can be successfully managed with endoscopic transpyloric stent placement and fixation (with video)

Cited by 97 publications

References 11 publications

Gastric per-oral endoscopic myotomy for refractory gastroparesis: results from the first multicenter study on endoscopic pyloromyotomy (with video)

Gastric per-oral endoscopic myotomy for refractory gastroparesis: results from the first multicenter study on endoscopic pyloromyotomy (with video)

Novel Diet, Drugs, and Gastric Interventions for Gastroparesis

Diabetic autonomic neuropathy of the gastrointestinal tract – etiopathogenesis , diagnosis, treatment and complications

Contact Info

Product

Resources

About